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� �pPLICATION f0�' <br /> '".E"'°'"" CONSTRUCTION ""`" <br /> LIN OF <br /> everett PERMIT -- --- <br /> BUILDING DEPARTMENT <br /> 259•eB10 TO BE COMPLETED IN INK- PLEASE PRINT � _�� - �� <br /> ❑ DEMOLITION ❑ COMBINATION I�9UILDING ❑ MECHANICAL PLUMBIN N <br /> O�y EN M�II�pORL55 GIIV ZiP PMONE <br /> ,/�/� �8�f s�/����lYqE�/iS �O�/ �� rr� .�uv �vr.trTi .;2 S"fJ - 9'.� 7 S� <br /> 1PL IIECIOROkS�ONER � MqL�0�11E55 �` CIiV ZI� PNONC <br /> /A/ O/J 1 l%� /L �__ �J �17 _ <br /> GENER�L CONIR1G10� ` � M�II�ODPESS C�1�3� / S/. Z�P oPONE LICENSE• <br /> � s'c�-vs srY <br /> �{� i-n �w a '.oA 3 s��Ti- /i'c PavSiOdn i!, o .S.vv�a..oss�S�i' 9�a fin t c•v=�w,p /�a7 <br /> MECII�NIL CONiP�LtDp / MAIL�DORE55 CIIV IIP pNONE LI[ENSE• <br /> PWMB�NOCON�R�WO� AIAII �DD�[55 ���� T��� ���ONG IICLYSE• <br /> cussor won�� <br /> ❑ NEW �J ADOITION �AL7ERATION ❑ PEPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPLINSERi ❑ BUILDING RELOCnTION <br /> veiwtlYYor wonn ir.Ds�or u`t[nui5 rtus uneni <br /> rco`�g' �DD �/�� <br /> OF CR�6t��- �1 <br /> Y� I ` � NiN fIDO / / . <br /> USEO�B i�o�wa — I HER[BY CERTIFY THAT I HAVE READ AND E%AMINED THIS AP� <br /> 7 /= � PLICATIONANDKNOWTHESAMETOBETRUEANDCORFECT.ALL <br /> LEO�L�ESCA�P��O,r� oqqre�r is��owr�a �owonetre rouncowes PROVISIONSOFLAWSANDORDINANCESGOVEFNINGTHISTVPE <br /> �A� �,3, �Y� �� � �0 � OFWORKWILLBECOMPLETEDWITHWHETHEqSPECIFIEDHERE• <br /> �o�_dLock�—oF IN OR NOT.THE GRANTING OF A PERMIT DOES NOT PqESUME TO <br /> _ � GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> - - � ANYOTHERSTATEOFLOCALLAWREGULATINGCONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> � � ,..� _ �/ ` SIGN4IUPB NiRACiOA OR A11i110RiZE0 AGE pATE /�-.�� <br /> G � ZL <br /> PPOJECT AOOAE55 �PVUf.�NiS CIIY BUSIN[SS ULk115E NO <br /> � � � <br /> PLUMBING MECHANICAL <br /> Np, TYPE OF FIXTUPE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> W�TER CLOSET�TOILET� A/C—n/HNOLG UNITS—HP. <br /> B�THTUB AEFRIGERATION UNITS—N F EA. <br /> V.VATORY�WASH B�SIN� 001�EP5—B.T U/H P. <br /> SHO WEP GAS FIRED A.C,UNITS—B.T.U. <br /> NITCHEN SINK d OISP FORCED Alii SYSTEMS—B.T U. M EA. <br /> OISMW�SMEfi WALIMEATERS—BT.U. M <br /> LAUNDRY TR�V UNIT HEATERS—B.T.U. M <br /> CLOTMES WASMER EVAPORATIVE COOLERS <br /> URINAL CLOTHESDRYERS <br /> ORINNING FOUNTAIN VENTILATION FAN <br /> FLOON DAAIN RANGE HOOD <br /> BRCKFLOW PREVENTERS WATER HEATER <br /> ROOF DRAINS—HAINLEADERS W OOD STOVE <br /> SINN(SEflVICE—BAR,ETC� METAL FIREPIACE d CHIMNEY <br /> FIHEPLACE INSERT <br /> NEALPUMP <br /> GAS PIPING <br /> EXHAUSTFAN <br /> SUBTOTAL ! SUB TOTAL <br /> PERMIT ! PCRMIT <br /> TOTAL fEE S TOTl1l FEE <br /> �AONi SEtO�LK �p �E��SEIB�Cn z� SiDE SELO�GN/� , Z��� QNLnn CHECK NUMBER� FEE RECE,IPT NO. <br /> ' r � O I—I�l D I /� —I��' , <br /> use zone �oi^nE^ y��pNIS�TE • FEES VALUATION fEE <br /> ❑res�+o <br /> tYPE Of CONSi <br /> OCCUPANCYGPOUP NOOFD�VfLUNOl1N1i5 BUILDING S <br /> � �•/V Ie-'� N� PWMBING <br /> SI2F OF BlDO / HO OV'S10RIE5 M�K OLC LO�O <br /> IB� .S/ � �/A MECHANICAL <br /> OTHER <br /> FIRE SPFINKLERS FEOUIREO ❑ VES O STATE BUIID�NG SURCHARGE <br /> STATEENERGVSUFCHARGE <br /> AVPUGfIOH�CG 9V Pl�NSCNECNEDBY AVP11 FORISSWNLEBV PUBLICWOHNS <br /> �77J{, � � TOTAL <br /> -�v <br /> PROPERTV OWNERS ARE RESPONSIBLE FOR DETERMINING ALL <br /> PROPERTY LINE IOCATIOYS AND RELATE�EASEMENTS. <br /> ....-. - ,-._. ....... _. . . . . ; . . „ . . . .,.� . .. _ <br /> .':.�.:AI:Si' .1: ..� . . . .. � ". . - . . . � ' . ;. . . . . . ..:. '.r �.y�".. .. .'i.._. .. <br />